HomeMy WebLinkAboutPermit Electrical 2000-4-11
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
The following project as submitted has the 0 10V':
zoning, and does not require specific land us
approval.. r C/'
2omn" ,
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Date f<.J.'-/
Authorized Signature _
4
DA TE : APR 11 2000
AMT RECD:2 $ 82.50
CHANGE:
CASHIER:f)59
ELECTRICAL PERMIT APPLICATION
City Job Number ()()~OOO;)"S-O(
3 . COMPLETE FEE SCHEDULE BELO\I
1.
LOCATION OF INSTAL~tION
'2.,4 4~ 1-1 (lttOIn
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
17 0 3 22- L. () 00 'lo5
Items Cost
Sum
JOB DESCijPTION I Dne
2.. <O'1le <t*""
-- I /
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
CrQalr-t-
1000 sq.ft. or less
Each additional 500
sq. ft or portion'
thereof
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder
$ 85.00
$ 15.00
, .
.$ 40.00
Expiration DateJO~/-() J
Constr Contr. Number 4ZQ(p
Expiration Date 12-IO-o~
Si,"~:;';;~"i'i"g~"i'iOi""
J /, 'Q ""<i> . V/. 'l.,
Q~'S''9 ~O &8 "\..
,n. ,Q,,"'.. <9". .
'>, "'Ql4' "'o(,:"''''O..;~..,~ .......o,@:""......, D.
Owners Namej~-r NA,I, 'n:'t?l'it?~~'
~'JoO ('1" Obl" 'f), q;"?~('1 \" New, Alteration or Extension Per Panel
Address '" "0_&~/", <9//) '?/,I'> ~'(,.I. 0/,&-"<>,.
".: u", (IV, cOb ~q? ~~ ~.QcQn"e Ci rcuit I
Phone .'. ~OO: 0,<<> ,''9.<,'),o''/'9/'", ~~~~~ A?d i t i on~l .
. '0;; ?"'1. J'o?", 9S<'!-ClrcUlt or WI th SerVIce
'.. 3" Ii, 19/&, 'ill. '(or Feeder Permi t
.., '01)';('; Q~.
. I 1'-1' 0,) ~ "
The installation is being made on ~E.S Miscellaneous (Service/feeder not included)
property I own whi~h is not intended ~ -Each installation
for sale, lease or rent. Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders'
Installation, Alterations
Electrical Contractor BUilders Eec;.Tl'\t or Relocation:
Address ,<is !vtan\'S()() Euo,ene ()f2. 9?4C)'L 200 amps or less $ 50.00
J ~~~~Q 201 amps to 400 amps $ 60.00
Ci ty E.uC\enf" Phone 4'6S'cw, 'iI ()'O-.)3 401 amps to. 600 amps $100.00
J- . ~ ~ q,<..6..Q1 all\ps to 1000 amps $130.00
Supervisor License Number ~l.qO-'S :;)>~ <$r:;)>O'O{l"M,. ~O amps/volts $300.00
~-.)3 ~c6'n~.ftW:;)>snlY $ 40.00
Q;o<X' 6'~ 6'0 _ 'f fy,
C. 'r$~p~~l~~e6Vi~es or Feeders
Ins~I-?~.&'~~~~~Eeration or Relocation
200 a~~::'~1;b- $ 40.00
201 a"!'~.-'~_4U1t-amps $ 55.00
Over 4~~~1?0 amps $ 80.00
Over 600 ~ or 1000 volts see "B" above
Branch Circuits
$ 35.00
35 CO
City
OIlNER INSTALLATION
$
2.00
Owners Signature:
$ 40.00
$ 40.00
$ 20.00
$ 36.00
---------------------------------------
5. SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
~lS .f:? U
DATE:
RECEIPT II:
RECEIVED BY: